| 刘奕,赵浩天,薛红元.下腔静脉短轴切面各指标评估急重症患者容量负荷[J].中国医学影像技术,2021,37(10):1477~1481 |
| 下腔静脉短轴切面各指标评估急重症患者容量负荷 |
| Indexes of inferior vena cava on short axis section for evaluating volume load of acute and severe patients |
| 投稿时间：2020-10-25 修订日期：2021-07-09 |
| DOI：10.13929/j.issn.1003-3289.2021.10.010 |
| 中文关键词: 腔静脉,下 容量负荷 超声检查 |
| 英文关键词:vena cava, inferior volume load ultrasonography |
| 基金项目:河北省2020年度医学科学研究课题计划（20200714）。 |
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| 中文摘要: |
| 目的 观察经下腔静脉（IVC）短轴切面测量IVC各指标评估急重症患者容量负荷的价值。方法 收集109例因突发呼吸困难和/或血流动力学紊乱而接受床旁急诊超声检查患者，分别经IVC长轴切面测量其前后径（IVC-ad），经短轴切面测量其短径（IVC-sd）、长径（IVC-ld）及横截面积（IVC-csa），并计算其变异率及IVC长短径比值（IVC-ratio）。绘制受试者工作特征（ROC）曲线，观察上述各指标评估容量负荷的效能。结果 根据肺超声表现将患者分为容量过负荷组（n=30）与非容量过负荷组（n=79）。容量过负荷组IVC-admax、IVC-sdmax、IVC-csamax和IVC-ldmax均高于非容量过负荷组（P均<0.05），而IVC-ratio、IVC-ad变异率、IVC-sd变异率、IVC-csa变异率均低于非容量过负荷组（P均<0.001）；组间IVC-ld变异率差异无统计学差异（P>0.05）。分别以16.85 mm、15.20 mm、20.05 mm、3.42 cm2、27.27%、28.21%、30.88%和1.32为IVC-admax、IVC-sdmax、IVC-ldmax、IVC-csamax、IVC-ad变异率、IVC-sd变异率、IVC-csa变异率和IVC-ratio的截断值，其预测容量过负荷的敏感度分别为83.30%、83.30%、80.00%、70.00%、78.50%、84.80%、78.50%和94.90%，特异度分别为68.40%、65.80%、58.20%、75.90%、76.70%、70.00%、70.00%和76.70%，曲线下面积（AUC）分别为0.806、0.790、0.668、0.770、0.820、0.830、0.783和0.918。结论 于IVC短轴切面测量IVC各指标对评估急重症患者容量负荷具有良好价值。 |
| 英文摘要: |
| Objective To observe the value of indexes of inferior vena cava (IVC) measured on the short axis section for evaluating volume load in acute and severe patients. Methods Totally 109 patients with sudden dyspnea and/or hemodynamic disorder who underwent bedside emergency ultrasound were enrolled. The anteroposterior diameter of IVC (IVC-ad) on the long axis section, short diameter of IVC (IVC-sd), long diameter of IVC (IVC-ld) and cross-sectional area of IVC (IVC-csa) on the short axis section were measured, and the variation rate of these indexes and the ratio of IVC long diameter to short (IVC-ratio) were calculated. The receiver operating characteristic (ROC) curve was drawn to observe the efficiency of the indexes of IVC for evaluating volume load. Results According to pulmonary ultrasound, the patients were divided into volume overload group (n=30) and non-volume overload group (n=79). IVC-admax, IVC-sdmax, IVC-csamax and IVC-ldmax of volume overload group were higher than those of non-volume overload group (all P<0.05), while IVC-ratio, IVC-ad variation rate, IVC-sd variation rate and IVC-csa variation rate of volume overload group were lower than those of non-volume overload group (all P<0.001). There was no significant difference of IVC-ld variation rate between groups (P>0.05). Taken 16.85 mm, 15.20 mm, 20.05 mm, 3.42 cm2, 27.27%, 28.21%, 30.88% and 1.32 as the cut-off value of IVC-admax, IVC-sdmax, IVC-ldmax, IVC-csamax, IVC-ad variation rate, IVC-sd variation rate, IVC-csa variation rate and IVC-ratio, the sensitivity of predicting volume overload was 83.30%, 83.30%, 80.00%, 70.00%, 78.50%, 84.80%, 78.50% and 94.90%, with specificity of 68.40%, 65.80%, 58.20%, 75.90%, 76.70%, 70.00%, 70.00% and 76.70%, while the area under the curve (AUC) was 0.806, 0.790, 0.668, 0.770, 0.820, 0.830, 0.783 and 0.918, respectively. Conclusion IVC indexes measured on the short axis section of IVC had good value for evaluating volume load of acute and severe patients. |
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